Provider Demographics
NPI:1265253983
Name:SHAVER, KIMBERLY LOUISE (MSW, LCSWA)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:LOUISE
Last Name:SHAVER
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1152 LENOIR RHYNE BLVD SE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-5168
Mailing Address - Country:US
Mailing Address - Phone:828-409-3799
Mailing Address - Fax:
Practice Address - Street 1:1152 LENOIR RHYNE BLVD SE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-5168
Practice Address - Country:US
Practice Address - Phone:828-485-1320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-24
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0211941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical